IMPLEMENTATION OF TOTAL QUALITY MANAGEMENT AFTER RECONFIGURATION OF SERVICES ON A GENERAL-HOSPITAL UNIT

In 1992 the New York State Office of Mental Health issued a statewide plan for mental health services to reduce the number of inpatient beds in state-run facilities from approximately 11,000 to between 6,000 an d 8,000 by the year 2000, This reduction resulted in at least a 25 per cent increase in psychiatric beds at local general hospitals. In 1992 Albany Medical Center Hospital's department of inpatient psychiatry es tablished an interdisciplinary committee to address changes resulting from the reconfiguration of services to chronic mentally ill persons. The committee established procedures to use the principles of total qu ality management to respond to problems and to continuously improve th e therapeutic milieu. The authors describe how these principles were u sed to create a patient satisfaction survey, to examine and improve pa rt of the hospital admissions procedure, and to review and revise trea tment planning documentation. A concurrent review committee reviews pa tients' records to ensure accuracy of documentation and quality of car e.